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1BSC2086L Case Study #2Modified from:The Tired Swimmer: A Case Study on the Nervous SystemBy Allison Russo, Morgan Falk and Phil StephensNational Center for Case Study Teaching in ScienceSpring 2020For this assignment, use the case study information below to apply the material that you are learning in Anatomy and Physiology II lab. Thiscase study correlates with both the cardiovascular effects of exercise lab and the muscles and EMG lab performed in class. Please be sure to pay attention to the details and requirement of the guidelines.Unlike case study #1 which you completed as a group,this case study must be completed individually. Summarize all information in your own words and reference sources appropriately. For more information regarding plagiarism, please refer to your syllabus and the USF Academic Integrity Policy. In order to receive credit for the assignment, both a full digital copy submitted through Turnitin and a matching hard copy submitted in class are required. Case InformationAnnie is a swimmer for her college. Recently, she has experienceddecreased performance in the pool, resulting in slower timeseven though she hasbeen working hard in practice. Additionally, she has been plagued with blurry vision and eye strain. Her eye strain hasbecome progressively worse over the last month. Any typing done for school makesher fingers acheand feel weak, and sometimes they seem to not function at all. Simple physical activities such as walking a flight of stairs makesher feel extremely fatigued and leavesher gasping for air. On top of these symptoms, she is constantly tired. Due to her symptoms, Annie decided to see her family doctor who referred her to a neurologist. After running a series of test, the neurologist determined that Annie’s nerve function was normal as there was no evidence for nerve fatigue and the nerve conduction velocity was fine. However, when testing the muscle, it was determined that the muscle response decreased quickly during repeated nerve stimulation. This suggested that muscle response fatigued. Lab tests were performed as well in order to reach a diagnosis. When an edrophonium test was performed, Annie reported feeling much better, but only for a short period of time. Additionally, when looking at Annie’s blood work, it was determined that there were an abnormally high level of antibodies in her blood. It was alsodiscovered that Annie hasa tumor on her thymus. Case Study GuidelinesYou will be responsible for writing a 2-3page response to this case. Yourcase study should notexceed 3 pages. Similar to case study #1, you will need to conduct background research in order to complete this assignment, providing appropriate information to support your diagnosis. You must use a minimum of two references, one of which must be your Lt background information. Your reportshould be type-written in 12-point font, double-spaced, and have 1 ¼-inch left and right marginsand 1-inch top and bottom margins.Spelling, grammar and quality of writing will count! All writing should be in the correct tense and in the passive voice (i.e. do not use the terms ‘I’ or ‘We’). You must submit a Word doc or docx file. Other file types will not be accepted. For more information, please be sure to refer to the ‘Guidelines for Case Studies’ document posted in Canvasand provided to you in class.
2Title: Include a title meaningful to the case study, your name, the course, the section number and the date. Introduction: Using background information gathered on the presented topic, write an introduction for your case study.Don’t simply lay out the required information, be sure to tie your introduction together and include proper transitions.You should not be moving through your introduction as if it is a list. In a narrative format, be sure to provide details on the following:1.Briefly describe both the macro and micro (cellular) anatomy of a skeletal muscle. 2.Define muscle fatigue and describe some of the causes of this condition.3.Describe the neuromuscular junction. Be sure to include details regarding the anatomy and physiology of the neuromuscular junction, describing how an action potential and acetycholine are involved in this junction. 4.Describe Electromyography. What does it show?5.Briefly describe the function of antibodies. Additionally, define what antigens areandwhat role they play in antibody production. Diagnosis: Basedon the information provided regarding the patient, please diagnosis her condition. In your diagnosis, please describe how her symptomsand medical tests led you to this conclusion. What specific tests may have been performed in order to diagnose the patient? Be sure to apply the information you learned in lab in order to complete the diagnosis. Prognosis and Medical Treatment Plan: Based on the diagnosis, describe the patient’s prognosis and any necessary long term medical treatment. In what wayswould the outlook for the patientbe differentif no treatment was provided?How would no treatment impact daily life?Conclusion:Synthesize the information provided in your case study. Be sure to adequately wrap up the information presented and highlight the important details from your report. References:The citation style used in the natural sciences is the CSE (Council of Science Editors) citationstyle. Please referto the bottom of page 2 oftheGuidelines for Case Studiesdocument provided to you in classand posted in Canvas. Direct quotes may not be used. All information used from another source must be paraphrased and cited appropriately (both within the text and the reference section). AT LEAST2different references are required. One of these references must be the Lt background information. The additional outside references must either be a textbook or a scientific journal article, not a blog or other non-scientific website. Tools used to locate electronic copies of journal articles that might be pertinent to your topic include ISI Web of Science (portal can be accessed through theUSF Library website, www.lib.usf.edu) and Google Scholar (scholar.google.com). The library has a guide on how to get started on research and finding reference articles at http://guides.lib.usf.edu/howtoguides. There is also an online textbook site at http://www.ncbi.nlm.nih.gov/bookswhere you can search for textbooks dealing with your topic.NOTE:Wikipedia is an encyclopedia and is not an acceptable reference for this course. However, like any encyclopedia, it might serve as a starting point for research, since Wikipedia uses citations and references.
3Please beware! If you use outside sources for information but only list the sources in the reference section and not within the text, you will lose 50% of the possible points on your case study assignment. Also, please note that the2-3 page case study limit does not include the reference section. To submit your case studyto Turnitin, go to ‘Assignments’in Canvas, click on ‘Case Study#2’,then on the‘Submission Upload’ button in the assignment inbox.Be sure that you click the ‘Submit’ button after uploading the file. You will only be allowed to submit Microsoft Word doc and docx file types.You will not receive credit for this assignment unless you submit the full document to Turnitin along with a matching hard copy in class. It is your responsibility to ensure that your document is uploaded correctly. Do not wait until the last minute to submit your assignment.

Nervous System

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Course

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Introduction

Skeletal muscle is among the significant muscles in the body. This type of muscle is a striated muscle tissue that operates as a volunteer in the somatic nervous system. In many cases, skeletal muscles are usually attached to bones by tendons, which are collagen fibers (Levenberg et al, 2005)

Skeletal muscle is best known for its ability to enhance movement by contraction. It also stops the movement by resisting gravity in order to maintain posture. The skeletal muscle also controls the functioning of the internal organs. Every skeletal muscle consists of a variety of integrated cells and tissues such as the skeletal muscle fibers, nerve fibers, blood cells, and connective tissues. It has three overlapping layers of connective tissue that is known as Mysia. This tissue enclose the muscle and its major role is providing structure to the muscle as well as compartmentalize the fibers in the muscle. Epimysium, a shield of an irregular thick tissue, wraps the skeletal muscle. The role of the epimysium is to enhance the contraction of the muscle while keeping its structure. The shield also ensures that the muscles move independently without interruption from other muscles.

Muscle fatigue is defined as the decrease in the ability a muscle to bring about force (Allen et al, 2008). It results in muscles feeling weak and tired. Muscle fatigue can be caused by rough exercise, old age, sleep deprivation as well as medical conditions such as depression, pregnancy, cerebral palsy, and chemotherapy, HIV, and stroke. The initial signs and symptoms of muscle fatigue are feeling weak and tired in the muscle. Other symptoms include muscle crump, shortness in breath, and pain in the muscles, muscle twitching, and trembling.

A chemical synapse that connects a muscle fiber to a motor neuron is called a neuromuscular junction. It is also known as a myoneural junction. The neuromuscular junction is made up of a presynaptic terminal, a postsynaptic cell, and a synaptic. In this case, the presynaptic terminal is defined as the axonal terminal that is found in a motor neuron. Synaptic vesicles present on the axonal terminals have neurotransmitters that are emitted after receiving a nerve impulse. The primary role of the neuromuscular junction is to allow a signal to be transmitted by the motor neuron to the muscle fiber, therefore, resulting in muscle contraction. The postsynaptic cell is the skeletal muscle fiber which enables the formation of the synapse by the motor neurons. The synaptic is the gap that separates the presynaptic ending and the postsynaptic membrane. It is a tiny space that enables the neurotransmitters to dissolve and move to the other side of the neuromuscular junction. It is rich in enzymes that digest the excess neurotransmitters. The sarcolemma of the skeletal muscles that are found at the neuromuscular junction has many folds referred to as postjunctional folds. The folds increase the surface area for the action of the neurotransmitter. The folds also contain acetylcholine receptors, which enhance the diffusion of potassium and sodium ions by opening the cation channels.

The contraction cycle of the skeletal muscle is initiated by the calcium ions as they enter into the cell forming actin-myosin bridges. Asa result, the skeletal muscle contracts. The acetylcholine released into the cleft does not survive for long. As soon as it enters the synaptic cleft, the acetylcholinesterase metabolizes it, and the choline formed gets absorbed by the presynaptic neurons. The resultant of all these activities is the elimination of any possible effect; therefore, the muscle stops contracting.

Electromyography is the process of measuring the electrical activity of the muscle response to a nerve’s stimulation of the muscle. This particular test aids in the detection of neuromuscular abnormalities. The test involves small needles being inserted into the muscle through the skin, and then the action of the muscle is displayed on a screen through those small needles(the electrodes). The test shows the activity of the muscles.

Antibodies are Y-shaped proteins that are released into the body by the immune system to fight harmful intruders in the body. The immune system generate antibodies whenever an antigen gets into the body. Antigens are the foreign substance that triggers the production of the antibodies by the immune system. Antigens cause allergies, infections and diseases.

An Electromyography procedure shows that the patient was suffering from minor fatigue. Due to the available tumor in the patient’s thyroid, there arises a need to test for thyroid cancer. The possible cause of the patient’s sickness is the availability of chlorine in the swimming pool that got absorbed into the body system, therefore, making the body release more antibodies. “The activity that involves any of halogens is in the environment is directly proportional to the atomic weight of that particular halogen. The translation of this is any halogen can displace the element with a higher atomic weight, but cannot displace an element with a lower atomic weight,” J.C. Jarvis.

Administration of supplements rich in iodine is recommended to the patient for long-term treatment and wellbeing. In a case where no medical treatment was provided, the life of the patient may be at risk of getting thyroid cancer, which is hard to treat at a late stage.

Conclusion

Muscle fatigue may be caused by infection or disease due to the penetration of the antibodies into the body through the skin. As a result, the body may feel weak and tired. In this case, the Electromyography process is necessary in order to measure electrical activity or muscle response. The results of the test may help to rule out the possible cause of the patient’s ailment.

References:

Levenberg, S., Rouwkema, J., Macdonald, M., Garfein, E. S., Kohane, D. S., Darland, D. C., …

& Langer, R. (2005). Engineering vascularized skeletal muscle tissue. Nature biotechnology, 23(7), 879-884.

Allen, D. G., Lamb, G. D., & Westerblad, H. (2008). Skeletal muscle fatigue: cellular

mechanisms. Physiological reviews, 88(1), 287-332.